Boutonnerie Deformity/Mallet Finger/Jersey Finger
Boutonniere Deformity Physical Exam
*Boutonniere: PIP flex, DIP extend* Swan neck: PIP extend, DIP flex
What is a Boutonniere Deformity
*Extensor tendon slip injury* associatd with dorsal lip fx's
Cause of Boutonniere Deformity
*Finger struck by object* or related to *rheumatoid arthropathy*
Boutonniere Deformity Tx
*Splint in full extension* for up to 6 weeks if associated with tendon tear. *Buddy tape 4-6 weeks* Return to play or work once pain is controlled
Cause of Jersey Finger
Contact sport athlete who reaches out with *flexed fingers* to grab a jersey and opponent pulls away causing sudden extension
Cause of Mallet Finger
Direct blow to the fingertip
What is a Mallet Finger
Disruption of the terminal *slip of the extensor tendon* at the *DIP joint* (Differs from Boutonniere Finger where extensor tendon is suck at PIP joint) Most often involves middle finger
Mallet Finger Tx
Finger splint
Jersey Finger Physical Exam
Inability to *flex the DIP joint*
Mallet Finger vs Jersey Finger
Mallet: inability to EXTEND DIP Jersey: inability to FLEX DIP
Mallet Finger Physical Exam
Pain over dorsum of DIP *Extensor lag* due to unopposed flexion HALLMARK: *inability to extend the DIP* joint fully, resulting in a flexed DIP at rest
What is a Jersey Finger
Rupture of the *flexor digitorum profundus tendon* Usually overlooked as jammed finger Involves ring finger 75% of the time
Jersey FingerTx
Splint in flexion. Then Surgery